Hamaspik Medicare Select (HMO D-SNP) is a Medicare Advantage Special Needs plan that serves dual eligible members. ‘Dual eligible’ is a term referring to those individuals who qualify for both Medicare and Medicaid.
A Medicare Advantage Special Needs plan offers you a different way to receive your Medicare services through a private, Medicare-approved insurance company. Our plan includes care managers and a member services team who are ready to provide comprehensive support.
Our plan covers everything that Medicare covers, plus additional benefits including Part D prescription drugs, vision benefits and over-the-counter health products—all with $0 premium! Finally, these benefits are covered in one health plan called Hamaspik Medicare Select.
You are eligible to enroll in Hamaspik Medicare Select if you meet the following requirements:
- You are entitled to Medicare Parts A and B due to your age or disability
- You are eligible for Medicaid benefits in the State of New York
- You live in our service areas in
Once you have verified that you meet the eligibility requirements listed above, call us toll free, and a licensed sales representative can help you enroll.
Our staff are available to come to your home to explain the benefits of Hamaspik Medicare Select and determine your eligibility. If you choose to enroll, they can also help you complete the application form.
If you choose, you can print and mail us your enrollment application. Click the link below to download the form and send us a completed copy.Link to Enrollment Application
We will contact you once your application has been processed. In most cases, your enrollment will be effective on the first day of the month following the date you signed the enrollment form. If you have a question or need assistance, feel free to contact Member Services.
Medicare beneficiaries can also enroll in Hamaspik Medicare Select through the CMS Medicare Online Enrollment Center via their website. Follow the link to explore options and find important contact information.
If you need assistance, our dedicated Member Services Department can help.
Call us between the hours of 8:00am and 8:00pm, 7 days a week, or leave a message after-hours with our answering service, and someone will be in touch.
TTY/TDD users call 711
Understand the services that are covered by your Hamaspik health plan
Resolve a concern you are having about your healthcare services
Find a provider or change your PCP
Replace a lost ID card
Get a referral
Make a complaint or give us positive feedback
Answer a question about a process or status update
When you enroll in Hamaspik Medicare Select, you have access to all of the doctors, healthcare
professionals, medical groups, hospitals and healthcare facilities that are part of the Hamaspik
Medicare Select network.
An important first step is to choose a Primary Care Physician (PCP). Your PCP is your main healthcare provider and arranges for you to receive preventive care and other routine medical services. He or she also coordinates your benefits, helps you manage your ongoing health concerns, and teaches you to make healthy lifestyle choices. If you need a specialist, your PCP can connect you to a local in-network doctor.
Our provider network includes hundreds of physicians in every county within our service area, covering your primary care needs plus a wide range of specialists. The network also features many of New York’s leading hospital systems and their affiliated doctors.
Visits to your primary care physician and specialists
Inpatient and outpatient hospital care
Emergency and urgent care
Home health services
Durable medical equipment
Mental health services (inpatient and outpatient)
24-hour nurse hotline
Outpatient diagnostic tests and therapeutic services/supplies
Outpatient rehabilitation services including physical therapy, occupational therapy and speech/language pathology
Over-the-counter health items
Part D prescription drugs
Skilled nursing facility care
Vision benefits including eye exams and eyeglasses
For a complete list of services covered, please review your Evidence of Coverage by clicking the links below. These resources include detailed information about all your benefits as well as information about any coverage limits or authorization requirements.
Hamaspik Medicare Select includes your Medicare prescription drug coverage (also known as Medicare Part D). Please review the following information.
Hamaspik works with Magellan Rx Management, a pharmacy benefit manager, to provide our Medication Therapy Management Program (MTMP). This program is a free service for all eligible members, and although it is voluntary, we encourage you to participate. You will receive notification of eligibility within 60 days of enrollment.
A key component of the program is the Comprehensive Medication Review (CMR), which you
will complete with one of our pharmacists during a telephone consultation. The CMR
typically takes between 15 and 30 minutes. During that time, the pharmacist will answer
any questions you have about your medications, the best time to take them, and more.
After the conversation is complete, a written summary of the discussion will be sent to you within 14 days. The written summary will include a letter, personal medication list and medication action plan. We encourage members to bring these documents to their physician visits to discuss the information provided.
In addition to CMR, members who participate in MTMP will be included in various Targeted Medication Reviews (TMRs) conducted throughout the year on a quarterly basis. TMRs use pharmacy claims data to assess eligible members’ medication profiles for medication-related issues or gaps in care. Any recommendation that is identified through the TMR will be sent to your physician so they may assess it during your next visit.
If you are found to be eligible for the MTMP, you will be automatically enrolled in the program. If you do not wish to participate, notify us at any time by calling 1-800-424-9342, and we will remove you from the MTMP. Hours are 9:00am to 5:00pm, Monday to Friday.
As a member of Hamaspik Medicare Select, you may be eligible for extra help in the form of a Low Income Subsidy, which helps you pay for your prescription drugs and copayments. Regardless of your income, all members receive the same high quality of care provided through our plan. However, you must continue to pay your Part B premium.
Hamaspik works with Magellan Rx Management, a pharmacy benefit manager, to provide our Medication Therapy Management Program (MTMP). This program is a free service for all eligible members, and although it is voluntary, we encourage you to participate. You will receive notification of eligibility within 60 days of enrollment.Member Rights & Responsibilities
Follow the link for the required Hamaspik Medicare Select
Your Summary of Benefits includes information on what services are covered by Hamaspik Medicare Select and other important information about the Plan.
Your Evidence of Coverage includes detailed information about your Medicare-covered health benefits and prescription drug coverage.
Hamaspik Medicare Select has a wide range of participating pharmacies in our plan network. Use the locator tools to view a list of national pharmacy chains or to find a pharmacy that is close to your home
The Formulary is a list of prescription drugs, including brand name and generic drugs, prescribed by practitioners to help their patients. Hamaspik Medicare Select covers all the prescription drugs included in the document.
Hamaspik Medicare Select covers a number of health items at no cost to you. Browse the OTC Product List to make a purchase under the plan.
Hamaspik Medicare Select has been contracted with Siver & Fit for fitness and acupuncture benefits
Do you need someone to file an appeal or complaint for you? If so, use the Appointment of Representative Form to designate an Authorized Representative. This individual can help you with matters related to your healthcare needs.
Follow the link for the Low Income Subsidy premuim summary chart.
Our Privacy Notice details important information about patient confidentiality per HIPAA Privacy Rules.
The ANOC (or Annual Notice of Changes) is a summary of the benefits that have changed in 2021, compared to 2020 benefits
Prescription Drug Request for Reimbursement
Hamaspik Medicare Select complies with federal civil rights laws and does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. We also provide the following:
If you need services, contact Member Services. Or, if you believe Hamaspik has not given you these services or has treated you differently for any reason, you can file a grievance with Hamaspik:
Mail: Hamaspik Medicare Select Attention: Grievances and Appeals 58 Route 59, Suite 1 Monsey, NY 10952
In person: at the address listed above
For TTY/TDD services, call 711
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights via:
Web: OCR Complaint Portal at
Mail: U.S. Department of Health and Human
200 Independence Avenue SW, Room 509F,
Washington, DC 20201
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html
For TTY/TDD, call 800-537-7697
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If you have a concern about your health care or would like to file a complaint about Hamaspik Medicare Select, please contact Member Services within 60 days of the problem. We want to understand your concerns and help you to resolve them. Depending on the situation, your case will be handled as a grievance (or complaint) or an appeal. You can file a grievance or complaint in writing, over the phone, via fax or email.
(You can find detailed information about grievances and appeals in your Evidence of Coverage.)
Mail: Hamaspik Medicare Select Attention: Grievances and Appeals 58 Route 59, Suite 1 Monsey, NY 10952
Phone: 1-833-426-2774 For TTY/TDD services, call 711
Please contact Members Services if you would like to obtain information about the aggregate number of grievances, appeals and exceptions that have been filed with Hamaspik Medicare Select.
You can also file you Grievance about Hamaspik Medicare Select with CMS, by calling 1-800-MEDICARE, or online at the Medicare.goc complaint website at: medicare.gov
After you file a grievance, Hamaspik Medicare Select looks carefully into your case and will seek to resolve the problem right away. We will respond with the following:
We will notify you of our decision and reasoning within
30 days of when we have all the necessary information to
answer your complaint (or within 24 hours for expedited
grievances). If we do not agree with some or all of your
complaint, or refuse to take responsibility for the
problem, we will let you know. Our response will include
reasons for this answer.
You will be informed on how to appeal a decision and will be provided any necessary forms. If we are unable to make a decision about your complaint due to missing information, we will also notify you.
To appeal a decision about your health care services, please follow these guidelines:
If you are not satisfied with the services you have
received from Hamaspik, you (or someone on your behalf)
may submit a complaint directly to Medicare by calling
1-800-MEDICARE or 1-800-633-4227. Or you can file your
grievance with Medicare on-line by using the following
If your service request has been denied, we also encourage you to contact Member Services. There are many times when a member may ask Hamaspik Medicare Select to approve a treatment or service in the form of an exception request. To get approval, call 833-426-2774 or send your request in writing:
Hamaspik Medicare Select
Attention: Care Management
58 Route 59, Suite 1
Monsey, NY 10952
Hamaspik Medicare Select makes a coverage decision every time we decide what services are covered and how much we will pay. You or your doctor can also contact us to request a coverage decision if you are unsure if a particular medical service is included in your plan. You may also appeal this determination.
For assistance with filing a coverage decision or appeal, contact Hamaspik Medicare Select Member Services. Your doctor, prescriber or lawyer can also submit a request on your behalf at any point in the appeals process, including requests for Part D prescription drugs. Alternatively, you may appoint a friend, relative or another representative via the Appointment or Representative form above.
Hamaspik Medicare Select has programs in place to ensure our members always receive safe, appropriate care. We are committed to providing the highest caliber of healthcare services; therefore, we have created a Quality Improvement program aimed at maintaining this focus. For more information, please review the link below.
Hamaspik Medicare Select contracts with various providers, doctors and pharmacies who share our values of respect, excellence and the provision of high-quality care. These professionals make your healthcare a priority and pledge to honor the unique cultures and traditions of our diverse member base.
It is important to know which providers are part of our network because, with limited exceptions, you must use network providers to get your medical care and services while you are a member of Hamaspik Medicare Select. The only exceptions are: